Bajaj Allianz CSC Bachat Plus

A Variable Insurance Plan

UIN: 116N132V01

Bajaj Allianz Life Insurance Company Limited

Bajaj Allianz CSC Bachat Plus
Part A
FORWARDING LETTER

Name of the Policyholder

Address

Dear

Sub: Issuance of the Policy under application for the life insurance towards Regular Premium plan dated

We would like to thank you for investing your faith in us.

Please find enclosed herewith your Policy Document, a copy of the Proposal Form and documents mentioned herein below, based on which
your Insurance Policy has been issued. This Policy is issued subject to Section 45 of the Insurance Act, 1938 as amended from time to time.
In case you have made any disclosures to the agent which has not been included in the Proposal Form, you are requested to intimate the
same in writing to the Company within 15 days of the date of receipt of this Policy failing which it shall be inferred that the disclosures made in
the Proposal Form are full, complete and according to your instructions wherein nothing has been concealed.

Document Type Specification of Documents provided Identification No.

Proposal Form
Age proof
Identity Proof
Address Proof
Within fifteen (15) days of the receipt of this Policy, you may, if dissatisfied with any of the terms and conditions for any reason, give the Company a written
notice of cancellation along with reasons for the same, and return the Policy Document to the Company, subject to which the Company shall send you a
refund comprising the Premium Allocation Charge [per Section 14b) below] plus Policy Account Value at the date of cancellation less the proportionate
mortality charge, if any, for the period on cover, and stamp duty charges.

For any queries kindly write to us at the below mentioned address and we assure and strive to provide you the best of services.

Authorised Signatory

Head- Underwriting

FOR BAJAJ ALLIANZ LIFE INSURANCE COMPANY LTD.

Your Policy Servicing Branch Address: Bajaj Allianz Life Insurance Company Limited
Toll Free Numbers: 1800 209 5858

Please read policy document, especially following clauses on

Regular Premium Decrease in Annual Premium, if any
Non-payment of regular premium and forfeiture, if any Termination

Disclaimer: In case of dispute, English version of policy bond shall be final and binding.

Bajaj Allianz Life Insurance Co. Ltd. Policy Document Ver. 1 (072015)
Bajaj Allianz CSC Bachat Plus
A Variable Insurance Plan
UIN: 116N132V01

Preamble
The Company has received a Proposal Form, declaration and the first Regular Premium from the Policyholder / Life Assured as named in this Schedule.
The said Proposal Form and declaration along with any statement, report or other document leading to the issue of this Policy and referred to therein
having been accepted and agreed to by the Company and the Policyholder as the basis of the contract of insurance, both parties to the assurance contract
do hereby further accept and affirm that the Policy, in consideration of and subject to due receipt of subsequent Regular Premium as set out in the
Schedule with all its parts (Policy Document and Endorsements if any), shall be subject to the terms and conditions as contained in this Policy.

POLICY SCHEDULE

Name of the Policyholder

Address
Address
Address
Pin code

Gender Date of Birth

Age at Entry Age

Name of the Life Assured

Policy No.
Product Name Bajaj Allianz CSC Bachat Plus
Product Code
Date of Commencement of Policy Unique Identification No: 116N132V01
Date of Commencement of Risk Date of Birth
Age Age
Gender Sum Assured (`)
Policy Term Higher of [ Sum Assured, PAV, 105% of
sum of Regular Premiums paid till the
Regular Premium (`)* Death Benefit date of death, Sum of Regular
Premiums paid till the date of death
compounded at 1% p.a. ]

Premium Paying Term Maturity Date

Premium Payment Frequency Maturity Benefit PAV with a minimum benefit of total
premiums compounded at 1%p.a. till
Maturity Date less amount of partial
withdrawals made.
Due Dates of Premium
* Excludes any applicable tax & cess.
PAV – Policy Account Value

Details of the Nominee

Nominee(s) Name Nominee(s) Age years

Relationship to the Life Assured
Appointee Name [in case the Nominee(s) is (are) a minor(s)]:
Relationship to the Life Assured

Bajaj Allianz Life Insurance Co. Ltd. Policy Document Ver. 1 (072015)
Bajaj Allianz CSC Bachat Plus
A Variable Insurance Plan
UIN: 116N132V01

Sales Representative Details

Name Code
Address
Phone Number e-Mail Id

REGULAR PREMIUM PAYABLE FOR SELECTED PREMIUM PAYMENT FREQUENCY: `

In Words: Rupees ……………………………………………………………………………….Only

Premium Allocation Rate

Allocation Rate for Regular Premium

Policy Year 1 80%
Policy Year 2 onwards 100%
For all other charges under the Policy, please refer to the Charges section of the Policy Document.

Applicable service tax will be deducted for all applicable Charges

Benefit Illustration

Policy Year 1 2 3 4 5
Premiums payable
Opening Balance in the individual Policy Account
Initial Premium allocation charge 0 0 0 0
Mortality charge
Interest credited (minimum floor rate)
Additional interest credited (AIR)
Death Benefit
Balance in individual Policy Account

To whom the Benefits are Payable: The Benefits are payable to the Policyholder or the Nominee(s) where a valid nomination has been registered by the
Company (in accordance with section 39 of the Insurance Act 1938), or the executors, administrators or the legal representatives who should take out
representation to the estate or to such persons as directed by the court of competent jurisdiction in India, limited at all times to the monies payable under
this Policy.
The Policy shall be subject to and governed by the terms of the Policy Document along with the Schedule contained herein and endorsements if any,
made from time to time and all these shall together form a single agreement
All taxes, including service tax, either existing or those that may apply in future (including enhancements of existing taxes) will be charged extra. Payment
of such taxes shall be the responsibility of the Policyholder.
Bajaj Allianz Life Insurance Company does not provide any warranty or assurance that the Policyholder will be, by virtue of purchasing this Policy, eligible
for any income tax or other tax rebate or relief.

Signed on behalf of Bajaj Allianz Life Insurance Company Limited for Policy No. ______________

Issued on <date>

Authorised Signatory

ON EXAMINATION OF THE POLICY, if the Policyholder notices any mistake, the Policy Document is to be returned for correction to the Company.
Bajaj Allianz Life Insurance Co. Ltd. Policy Document Ver. 1 (072015)
Bajaj Allianz CSC Bachat Plus
A Variable Insurance Plan
UIN: 116N132V01
Part B
DEFINITIONS & ABBREVIATIONS
This Policy is issued on the basis of the information given and the declarations
made by the Policyholder in the Proposal Form, which is incorporated herein
and forms the basis of this Policy. The following terms shall have the meaning
assigned to them as below. In the document, the singular includes the plural
and references to the male include the female where the context so permits.
1. Definitions & Abbreviations:
a) “Additional Interest Rate (AIR)” shall mean the guaranteed annualized rate of
return of 4% p.a. for the first five (5) Policy Years and 0.5% thereafter, and
which will be credited to the Policy Account at the beginning of each calendar
quarter after crediting the Policy Account with the Guaranteed Interest Rate
(GIR).
b) “Age” means age at last birthday.
c) “Annualised Premium” means the amount of Regular Premium payable by the
Policyholder in a Policy Year.
d) “Business Day” means the common working day of the corporate office of the
Company.
e) “Charges” means the charges applicable to this Policy as detailed in Section
14 and Section 15 below.
f) “Company” means BAJAJ ALLIANZ LIFE INSURANCE COMPANY LIMITED.
g) “Date of Commencement of Policy” means the date of commencement of the
Policy, as specified in the Schedule.
h) “Date of Commencement of Risk” means the date specified in the Schedule
(unless the Policyholder is informed otherwise by the Company) from which
the risk cover of the Life Assured commences under the Policy.
i) “Date of Discontinuance” means the date at the expiry of Grace Period when
the Policy enters the Discontinuance state on account of non-payment of the
Regular Premium due before the expiry of the Grace Period or Date of
Surrender of the Policy during the first five (5) Policy Years.
j) “Date of Surrender” means the date on which the Company receives the
written communication from the Policyholder to surrender the Policy.
k) “Death Benefit” has the meaning given in Section 4a) below.
l) “Discontinuance” means the state of the Policy that could arise on account of
non-payment of the Regular Premium due before the expiry of the Grace
Period or surrender of the Policy during the first five (5) Policy Years.
m) “Grace Period” means a period of fifteen (15) days for a monthly Premium
Payment Frequency and thirty (30) days for other than monthly Premium
Payment Frequency, from the due date of Regular Premium payment.
n) “Guaranteed Interest Rate (GIR)” shall mean the annualized rate of return of
1% per annum guaranteed for the entire term of the Policy and which will be
credited to the Policy Account at the beginning each calendar quarter.
o) “IRDAI” means the Insurance Regulatory and Development Authority of India.
p) “Life Assured” means the person named as the Life Assured in the Schedule
whose life is assured under this Policy.
q) “Maturity Benefit” has the meaning given in Section 4b) below.
r) “Maturity Date” means the date specified in the Schedule on which the Maturity
Benefit shall become payable to the Policyholder.
s) “Monthly Due Date” means the date corresponding numerically with the Date
of Commencement of Policy in each subsequent month.
t) “Nominee” means the person who has been nominated in writing to the
Company by the Policyholder, who is entitled to receive the Death Benefit
under the Policy.
u) “Paid-up Sum Assured on Death” is the reduced value of the Sum Assured on
death arrived at by multiplying the Sum Assured on death with the proportion
of the number of Regular Premiums paid to the total number of Regular
Premiums payable under the Policy.
v) “Policy” means the arrangements established by the Policy Document.
w) “Policy Account” is the individual account created and managed by the
Company for the Regular Premiums paid under the Policy.
x) “Policy Account Value (PAV)” is the accumulated value of the allocated
Regular Premium less the Mortality Charge, less service tax applicable on all
Charges, increased at the rate/s of GIR, AIR and any residual additions.
y) “Policy Anniversary” means the date corresponding numerically with the Date
of Commencement of Policy in each subsequent year during the Policy Term.
Bajaj Allianz Life Insurance Co. Ltd.
z) “Policy Document” means this policy wording, the Schedule (which is attached
to and forms part of this Policy, and includes any Annexure or endorsement to
it and if more than one then the latest in time) and the Proposal Form.
aa) “Policyholder” means the adult person named in the Schedule who has
concluded the Policy with the Company.
bb) ‘‘Policy Term’’ means the period between the Date of Commencement of
Policy and the Maturity Date, as specified in the Schedule.
cc) “Policy Year” means a period of one (1) year commencing from the Date of
Commencement of Policy or a Policy Anniversary thereof.
dd) “Premium Allocation Rate” means the rate specified in the Schedule, which net
of any service tax & cess will be applied to the Regular Premium paid to arrive
at the amount to be allocated into the Policy Account in respect of any Regular
Premium paid by the Policyholder.
ee) “Premium Paying Term” means the period specified in the Schedule during
which the Regular Premium is payable.
ff) “Premium Payment Frequency” is a regular time interval as specified in the
Schedule, at which the Regular Premium is payable during the Premium
Paying Term.
gg) “Proposal Form” means the Policyholder’s statements in the proposal for this
Policy submitted by or on behalf of the Policyholder along with any other
information or documentation provided to the Company prior to inception of
the Policy.
hh) “Regular Premium” means the amount payable by the Policyholder at regular
intervals during the Premium Paying Term, in amount and at the Premium
Payment Frequency, both, as specified in the Schedule.
ii) “Revival Period” means a period of two (2) consecutive years from the Date of
Discontinuance of the Policy, if the Policy is discontinued during the first five
(5) Policy Years, or from the due date of first unpaid Regular Premium, if the
Regular Premium is discontinued after the first five (5) Policy Years; during
which period the Policyholder is entitled to revive a Policy.
jj) “Schedule” means a document which is attached to and forms a part of this
Policy containing specific details of the Policy.
kk) “Sum Assured” is the amount as specified in the Schedule, for the Life Assured
under the Policy which is referred-to, to determine the Death Benefit after the
Date of Commencement of Risk.
ll) “Sum Assured on Death” is higher of (i) Sum Assured, (ii) 105% of Total
Premiums paid until the date of death or (iii) Total Premiums paid until the date
of death compounded at 1% per annum
mm) “Surrender Benefit” means the amount payable to the Policyholder on
surrender as per Section 8) below.
Part C
2. Policy Description
a) This is a non-linked, non-participating Regular Premium, individual variable
insurance product intended to be marketed through CSC distribution model.
b) On the Date of Commencement of Policy, the Company shall open a Policy
Account for the Policy. The Regular Premium paid by the Policyholder will be
allocated to the Policy Account after applying the Premium Allocation Rate and
applicable taxes as specified in the Schedule.
c) The mortality charge along with applicable service tax will be deducted from
the Policy Account at the beginning of every month.
d) Guaranteed Interest Rate (GIR) and Additional Interest Rate (AIR) on the
balance in the Policy Account will be credited at the beginning of each
calendar quarter throughout the Policy Term for one quarterly period for all
Policies in-force as on the date of crediting.
(i) The plan has a minimum floor rate, that is, the GIR, of 1% p.a. and is
guaranteed for the entire Policy Term.
(ii) The plan also has a guaranteed AIR of 4% p.a. for the first five Policy Years &
0.5% p.a. thereafter. The AIR will be credited after the GIR has been credited
e) Non-zero positive residual additions, if any, shall be credited to the Policy
Account at the end of each Policy Year starting from 5th (fifth) Policy Year in
order to meet the maximum reduction in yield criteria as stipulated in guideline
9(1) of IRDA circular ref: IRDA/Life/CIR/GLD/044/01/2014 dated 28/01/2014
(Guidelines – Process to be followed for filing of life products under the CSC
Distribution model). Such non-zero positive residual additions shall be
determined as:
(i) Gross Investment Yield earned in the shadow account at the end of each
Policy Document Ver. 1 (072015)
Bajaj Allianz CSC Bachat Plus
A Variable Insurance Plan
UIN: 116N132V01
Policy Year less
(ii) Actual yield earned in the Policy Account at the end of each Policy Year less
(iii) Yield referred in the reduction in yield at that duration as stipulated in guideline
9(1) of IRDA circular ref: IRDA/Life/CIR/GLD/044/01/2014 dated 28/01/2014
(Guidelines – Process to be followed for filing of life products under the CSC
Distribution model)
(iv) Yield earned on the Policy Account shall be calculated using the money
weighted rate of return method at end of each Policy Year.
(v) Residual Additions will not be applicable for Policies that are discontinued
during the lock-in period of 5 years and are subsequently not revived
f) The Policy does not in any way confer any right whatsoever on the
Policyholder or the Life Assured to otherwise share in the assets, the profits or
surplus of the business of the Company.
g) Polices issued to a Life Assured who is a minor shall mature only after the Life
Assured has attained majority.
3. Regular Premium
a) Regular Premium (and applicable taxes) is payable in full by the due date, as
specified in the Schedule. The Company does not have any obligation to issue
a notice that Regular Premium is due or for the amount that is due.
b) The Company will not accept any amount less than the Regular Premium (and
applicable taxes) due as the Regular Premium.
c) The Regular Premium once chosen at the Date of Commencement of Policy
cannot be changed subsequently.
4. Policy Benefits
a) Death Benefit
On the death of the Life Assured after the Date of Commencement of Risk but
before the Maturity Date, the Company, subject to Section 10, Section 11,
Section 12 and Section 25 below, provided the Policy has not been terminated
per Section 13 below and provided all Regular Premiums due are paid up-to-
date, shall pay the following Death Benefit to the Claimant. The Death Benefit
is the higher of:
i) Policy Account Value or
ii) Sum Assured on Death,
Both the above will be as on date of receipt of intimation of death at the office of
the Company.
Please note that the “Sum Assured on Death” is defined as the higher of (i)
Sum Assured, (ii) 105% of Total Premiums paid until the date of death or (iii)
Total Premiums paid until the date of death compounded at 1% per annum.
b) Maturity Benefit
The Maturity Benefit on the survival of the Life Assured to the Maturity Date,
provided the Policy has not been terminated as per Section 13 below, will be
Policy Account Value as on the Maturity Date subject to a minimum amount
equivalent to total premium paid less any partial withdrawals (both)
compounded at 1% p.a. till Maturity Date.
c) Claw Back Additions
In respect of Policy Account Value, non-zero positive claw back additions, if
any, shall be credited to the Policy Account in order to meet the maximum
reduction in yield criteria as mentioned in Section 2e) above.
Part D
5. Free Look Period
Within fifteen (15) days of the receipt of this Policy, the Policyholder may, if
dissatisfied with any of the terms and conditions for any reason, give the
Company a written notice of cancellation along with reasons for the same, and
return the Policy Document to the Company, subject to which the Company
shall send the Policyholder a refund comprising the Premium Allocation
Charge [per Section 11b)] plus Policy Account Value at the date of
cancellation less the proportionate mortality charge, if any, for the period on
cover, and stamp duty charges.
6. Non-payment of Regular Premium and Forfeiture
a) On Discontinuance of Regular Premiums due during the first five (5) Policy
Years, the life cover will be lapsed immediately on expiry of Grace Period. If the
Policy is not revived by the end of the Revival Period of 2 years from the due
date of first unpaid Regular Premium, the PAV as at the end of the lock-in
period of 5 years or the Revival Period, whichever is later, will be paid as
Surrender Benefit at the end of the lock-in period of 5 years or the Revival
Bajaj Allianz Life Insurance Co. Ltd.
Period, whichever is later, and the Policy will terminate immediately.
i. Non-zero positive residual additions will not be applicable for such policies.
However, GIR & AIR shall be credited to the Policy Account at the beginning of
each calendar quarter as mentioned above.
ii. The Policy shall not be treated as discontinued on non-payment of Regular
Premium if, within the Grace Period or the Regular Premium has not been paid
due to the death of the Life Assured.
iii. In case of death of the Life Assured after Date of Discontinuance during the
lock-in period, the PAV as on date of death shall be paid and the Policy
terminates immediately.
iv. On revival of the discontinued Policies, the risk cover shall be restored upon
receipt of all due and unpaid Regular Premiums without levying any interest or
fee or charge as on date of revival. Premium Allocation Charge due on the
premiums paid, if any, and Mortality Charge from the date of revival will be
charged.
b) On Discontinuance of Regular Premiums due after the first five (5) Policy
Years
i. The Policy Account shall be continued with life cover by levying all applicable
Charges under the Policy till the end of the Revival Period of 2 years. All the
benefits under the Policy will continue.
ii. If the Policy is not revived during the Revival Period of 2 years from the date of
first unpaid premium
1) The Policy shall be converted into paid-up policy immediately on expiry of the
Revival Period
2) Sum Assured on Death under the Policy will be converted to Paid -up Sum
Assured on Death.
3) On death after the end of Revival Period, Paid-up Sum Assured on Death or
the PAV, whichever is higher, as on the date of intimation of death will be paid.
4) On surrender or maturity, the PAV as on the Date of Surrender or maturity (as
applicable) will be paid.
5) All Charges applicable will continue to be deducted on the due dates from the
Policy Account. Mortality charges will be Paid-up Sum Assured on Death.
6) Non-zero positive residual additions, GIR and AIR shall continue to be credited
to the Policy Account.
7. Revival
a) If the Policy has been discontinued due to non-payment of due Regular
Premiums as per Section 6 above, then, such a Policy [which is in-force as per
Section 6b) above or in Discontinuance as per Section 6a) above] can be
revived subject to the following:
I The Company receives the request for revival from the Policyholder within the
Revival Period, provided the Policy has not been terminated as per Section 18
below
ii) Declaration of Good Health is submitted by the policyholder and any
underwriting by the company as per Board approved underwriting policy.
iii) On revival of the discontinued Policy that is discontinued before completion of
the first five (5) Policy Years, the Policy will be revived restoring the risk cover.
For discontinued Policy that was discontinued after the first 5 years, the Policy
will continue as before.
iv) On revival of the discontinued Policy all the due but unpaid Regular Premiums
will be collected without charging any interest or fee.
8. Surrender Benefit
a) The Policyholder may, at any time, surrender the Policy.
b) On surrender during the lock-in period of first 5 Policy Years, the PAV as at the
end of the lock-in period of five (5) years will be paid as Surrender Benefit at the
end of lock-in period and the Policy terminated immediately. The risk cover will
terminate immediately as on the Date of Surrender.
c) On Policy surrender after the lock-in period of the first 5 Policy Years of the
Policy, the Policy Account Value as on the Date of Surrender will be paid as
Surrender Benefit and the Policy will terminate immediately.
9. Flexibilities
The Policyholder may, subject to prior approval of the Company, exercise any
of the following options by using the application form specified by the
Company and meeting the conditions set out therein:
a) Partial withdrawal
i) Partial withdrawals are allowed anytime after five (5) Policy Years, provided:
Policy Document Ver. 1 (072015)
Bajaj Allianz CSC Bachat Plus
A Variable Insurance Plan
UIN: 116N132V01

1) Regular Premium for five (5) Policy Years has been paid in full and the Policy is declared in the Proposal Form, then without prejudice to the Company’s other
in-force. rights and remedies including those under the Insurance Act 1938, the
2) The Company has received a written notice from the Policyholder specifying following actions shall be taken:
the amount to be withdrawn. i) If the correct Age is such as would have made the Life Assured uninsurable
3) The minimum amount of withdrawal is ` 1,000/- and the remaining balance of under this Policy, the plan of assurance shall stand altered to such plan of
Policy Account Value after the proposed withdrawal is at least three (3) times assurance as is generally granted by the Company for the Life Assured correct
of the Annualised Premium. The maximum amount of withdrawal in any Policy Age, which will be subject to the terms and conditions as are applicable to that
Year is 25% of the Policy Account Value. plan of assurance. If it is not possible to grant any other plan of assurance, the
Policy shall stand discontinued/terminated with immediate effect by the
4) The partial withdrawal shall not result in termination of the Policy contract. Company and:
5) The Life Assured is not less than 18 years of Age at the time that the written 1) If the Policy is discontinued before the fifth (5th) Policy Anniversary, the
notice for partial withdrawal is received by the Company. Surrender Benefit, as per Section 8) above, shall become payable at the end
ii) The Company may at any time, by giving written notice of three (3) months in of the lock in period of five (5) Policy Year,
advance, vary the minimum/ maximum amount to be withdrawn and/or the 2) If the Policy is terminated after the fifth (5th) Policy Year, the Surrender Benefit
minimum balance in the Policy Account to be maintained after such partial shall be payable immediately.
withdrawals subject to prior approval from the IRDAI.
ii) If the Life Assured correct Age is higher than the Age declared in the Proposal
b) Changing the Premium Payment Frequency Form, the mortality charge/s payable under the Policy shall be altered
The Premium Payment Frequency may be changed at any Policy Anniversary corresponding to the correct Age of the Life Assured (the “corrected mortality
to any other (i.e., yearly, half yearly, quarterly or monthly) subject to the charge”) and the accumulated difference between the corrected mortality
minimum Regular Premium allowed for each Premium Payment Frequency charge and the original mortality charge from the Date of Commencement of
under the product on the date of receipt of request at the office of the Policy up to the date of such payment shall be recovered from the Policy
Company. Account
10. Loans iii) If the Life Assured correct Age is lower than the Age declared in the Proposal
No loan is available under this Policy. Form, the mortality charge payable under the Policy shall be altered
corresponding to the correct Age of the Life Assured (the “corrected mortality
Part E
charge”) from the next Monthly Due Date.
11. Charges
16. Assignment
The Charges mentioned below will be subject to the applicable service tax.
Assignment should be in accordance with provisions of section 38 of the
a) Mortality Charge Insurance Act 1938 as amended from time to time. [A Leaflet containing the
(i) The Mortality Charge will be deducted at the rate as applicable to the attained simplified version of the provisions of Section 38 is enclosed in Annexure AA
Age and gender of the Life Assured, on the Date of Commencement of Risk for reference]
and on each subsequent Monthly Due Dates. The Mortality charge may vary 17. Nomination
from Policy Year to Policy Year according to the attained Age of the Life
Nomination should be in accordance with provisions of section 39 of the
Assured at the time of deduction of the same.
Insurance Act 1938 as amended from time to time. [A Leaflet containing the
(ii) The Mortality charge per thousand Sum At Risk is given in Annexure 2. Sum at simplified version of the provisions of Section 39 is enclosed in Annexure BB
Risk means higher of [Death Benefit less Policy Account Value] or zero, where for reference]
Death Benefit is as defined in Section 4a) above. The Mortality Charge is
18. Termination Conditions
applied on the Sum at Risk under the Policy.
This Policy shall automatically and immediately terminate on the earlier
b) Premium Allocation Charge
occurrence of any of the following events:
The Premium Allocation Rate is mentioned in the Schedule. The balance is
a) On receipt of intimation of death of the Life Assured, at the Company’s office.
taken as the Premium Allocation Charge.
b) On payment Surrender Benefit.
12. Recovery of Charges
c) The Maturity Date,
Charges per Section 11) above, wherever applicable, will be recovered by the
deduction from the Policy Account Value. 19. Fraud, Misrepresentation and Forfeiture
13. Non-Participation in Profits Fraud, Misrepresentation and forfeiture would be dealt with in accordance with
provisions of Section 45 of the Insurance Act 1938 as amended from time to
This Policy shall participate only in the investment performance of the
time. [A Leaflet containing the simplified version of the provisions of Section 45
underlying Funds.
is enclosed in Annexure CC for reference]
Part F
20. Notices
GENERAL CONDITIONS
Any notice, direction or instruction under this Policy which may be in writing or
14. Suicide Exclusion in any kind of electronic/digital format and if it is to:
In case of death of the Life Assured due to suicide within one (1) year from the a) The Policyholder or the Life Assured:
Date of Commencement of Policy or the date of latest revival of the Policy, the
I Shall be sent either by hand, post, courier, facsimile, Short Messaging Service
Policy shall be void, and the Company’s liability shall be limited to the extent of
(SMS), Voice call, e-mail or through any other digital/electronic media to the
PAV, as on the date of death.
Policyholder or Life Assured to the address or communication/
The validity of the contract of insurance will be determined in accordance with correspondence details specified by the Policyholder in the Proposal Form or
the actual date of death of the Life Assured and not the date of intimation of as per subsequent most recent change of address and/or communication/
death. Any Charges recovered subsequent to the date of death shall be paid correspondence details intimation submitted by him to the Company.
back to Nominee or beneficiary along with death benefit.
ii) The Company shall not be responsible for any consequences arising out of
15. Age Proof non-intimation of change of the Policyholder’s address and/or
a) The mortality charge/s payable under the Policy is calculated on the basis of communication/correspondence details. In case the notice comes back to the
the Life Assured’s Age and gender as declared in the Proposal Form. If the Company undelivered to the Policyholder due to any reason, there shall be no
Age has not been admitted by the Company, the Policyholder shall furnish obligation upon the Company to make any attempt again towards dispatch of
such proof of Age as is acceptable to the Company and have the Age the notice which was returned undelivered.
admitted. b) The Company, shall be submitted by hand, post, facsimile or E-mail:
b) If the Age so admitted (the “correct Age”) is found to be different from the Age Bajaj Allianz Life Insurance Company,

Bajaj Allianz Life Insurance Co. Ltd. Policy Document Ver. 1 (072015)
Bajaj Allianz CSC Bachat Plus
A Variable Insurance Plan
UIN: 116N132V01
GE Plaza, Airport Road, Yerawada, Pune – 411 006
Toll Free No. 1800 209 5858 | Fax: 020-6602-6789
e-mail: customercare@bajajallianz.co.in
21. Electronic Transactions
The Policyholder agrees to adhere to and comply with all such terms and
conditions as the Company may prescribe from time to time with regard to all
transactions and hereby agrees and confirms that all transactions (other than
those requiring a written notice or communication under this Policy) effected
by or through facilities for conducting remote transactions including the
Internet, World Wide Web, electronic data interchange, call centres, tele-
service operations (whether voice, video, data or combination thereof) or by
means of electronic, computer, automated machines network or through other
means of telecommunication, established by or on behalf of the Company, for
and in respect of the Policy or its terms, or the Company’s other products and
services, shall constitute legally binding and valid transactions when done in
adherence to and in compliance with the Company’s terms and conditions for
such facilities, as may be prescribed from time to time.
22. Currency
All amounts payable either to or by the Company shall be payable in India and
in Indian Currency.
23. Waiver
Failure or neglect by either party to enforce at anytime the provisions of this
Policy shall not be construed or be deemed to be a waiver of either party’s right
here-in nor in anyway affect the validity of the whole or any part of this Policy
nor prejudice either party’s right to take subsequent action
24. Modifications
This Policy Document constitutes the complete contract of insurance. This
Policy Document cannot be changed or varied except by a Policy
endorsement in writing and signed by an officer of the Company authorized for
this purpose.
25. Payment of claim
The Death Benefit is payable to the Claimant. The Company shall be under no
obligation to make any payment of Death Benefit, unless and until the
Company has received from the Claimant any information and documentation
it requests, including but not limited to:
a) Written notice as soon as possible and in any event preferably within 180 days
of the death of the life/lives assured, and the circumstances resulting in the
death of the life/lives assured.
b) The Claimant’s proof of entitlement to receive payment under the Policy.
c) Original Policy Document.
d) Original death certificate of the life/lives assured issued by a competent
authority.
e) Medical cause of death, certificate from the doctor who last attended to the
life/lives assured or the hospital in which the death occurred.
f) If the death is due to unnatural causes including an accident; a copy of First
Information Report (FIR) and Post Mortem Report (PMR).
g) Any other document as may be asked for looking into the facts and
circumstances resulting to a claim under the Policy.
h) Without Prejudice to the right of the Company to insist for any of the documents
as mentioned herein above to examine the admissibility of claim for the Death
Benefit under the Policy of insurance, the Company may at its sole discretion,
consider claims where the claimant is unable to submit required documents.
All claims lodged beyond a period of 3 years from the date of death must be
supported by a Declaration of the Claimant explaining the reasons for not
lodging a claim earlier and suitably demonstrate to the satisfaction of the
Company that the reasons for delay was on account of facts beyond the
control of Claimant. The Company reserves the right to consider delayed
claims on merits only on satisfaction that there were sufficient grounds for not
preferring a claim within time.
26. Loss of Policy Document
a) If the Policy Document is lost or destroyed, then, subject to Sub–Section c)
below, at the request of the Policyholder, the Company, if satisfied that the
Policy Document has been lost or destroyed, will issue a copy Policy
Document duly endorsed to show that it is issued following the loss or
destruction of the original Policy Document.
b) Upon the issuance of a copy Policy Document the original Policy Document
Bajaj Allianz Life Insurance Co. Ltd.
will cease to have any legal effect.
c) The Company reserves the right to make such investigations into and call for
such evidence of the loss or destruction of the Policy Document at the expense
of the Policyholder, as it considers necessary before issuing a copy of the
Policy Document.
d) It is hereby understood and agreed that the Policyholder will protect the
Company and hold the Company harmless form and against any claims,
costs, expenses, awards or judgments arising out of or howsoever connected
with the original Policy Document or arising out of the issuance of a copy of the
Policy Document.
27. Governing Law
Any and all disputes arising out of and under this Policy shall be governed by
and determined in accordance with Indian law and by the Indian Courts.
28. Taxation
Payment of taxes, including service tax & cess, as applicable, shall be the
responsibility of the Policyholder. The Policyholder agrees to pay or allows the
Company to deduct/charge from any of the benefits payable or premium
received under this Policy, a sum on account of any tax or other payment which
may be imposed by any legislation, order, regulation or otherwise, upon the
Company, Policyholder or any other beneficiary, which in the opinion of the
Company is necessary and appropriate.
29. Status of Insurance Agent
The insurance agent is only authorized by the Company to arrange completion
and submission of the Proposal Form. The insurance agent is not authorized
to act as the Company’s legal representative and any representation made by
the insurance agent, which is against the express terms and conditions as
contained in this Policy shall not be binding on the Company. Information or
payment given to the insurance agent should not be considered as having
been given to the Company. Any specific information given to the insurance
agent at the time of solicitation of insurance business or negotiating the Policy
and not incorporated in the Proposal Form on the basis of which this Policy has
been issued, shall be deemed to have been concealed from the Company
knowingly and deliberately by the Policyholder. In absence of any specific
authorisation to an insurance agent to accept premium on behalf of the
Company and issue receipt thereof, payment made to an insurance agent
shall be considered from the date of receipt of the premium amount by the
Company. In the event of happening of any eventuality between the date of
payment of premium amount to the insurance agent and the date of receipt of
the premium amount by the Company, same shall be considered in
accordance with the terms and conditions as contained herein above as if the
premium was not paid as on the date of happening of the eventuality.
Part G
30. Grievance Redressal
In case the Policyholder have any query or compliant/grievance, he may
contact any nearest Customer Care Center during the Company’s office hours
from 9 am to 6 pm. Alternatively, he may communicate with the Company:
By post at: Customer Care Desk,
Bajaj Allianz Life Insurance Company Ltd.,
GE Plaza, Airport Road, Yerawada, Pune - 411006
By Phone at: Toll Free No. 1800 209 7272
By Fax at: 020-6602-6789
By Email: customercare@bajajallianz.co.in
If Policyholder is not satisfied with the response or does not receive a response
from the Company within fifteen (15) days, he may approach the IRDAI
Grievance Cell Centre (IGCC) on the following contact details:
By Phone:TOLL FREE NO: 155255
By Email: complaints@irda.gov.in
By post at: Consumer Affairs Department
Insurance Regulatory and Development Authority of India
9th floor, United India Towers, Basheerbagh, Hyderabad – 500 029, Andhra
Pradesh
By Fax at: +91- 40 – 6678 9768
The Policyholder can also register his complaint online at
http://www.igms.irda.gov.in/
31. Ombudsman
Policy Document Ver. 1 (072015)
Bajaj Allianz CSC Bachat Plus
A Variable Insurance Plan
UIN: 116N132V01

a) In case you are not satisfied with the decision/resolution of the Company, you Annexure AA
may approach the Insurance Ombudsman if your grievance pertains to any of Section 38 of Insurance Act, 1938 – Assignment and Transfer of Insurance
the following: Policies
i) Insurance claim that has been rejected or dispute of a claim on legal Assignment or transfer of a Policy should be in accordance with section 38 of
construction of the Policy the Insurance Act, 1938, as amended by Insurance Laws (Amendment)
ii) Delay in settlement of claim Ordinance dated 26.12.2014. The extant provisions in this regard are as
follows:
iii) Dispute with regard to premium
1. This Policy may be transferred / assigned, wholly or in part, with or without
iv) Non-receipt of your insurance document consideration.
b) The address of the Insurance Ombudsman is provided as Annexure 1attached 2. An assignment may be effected in a Policy by an endorsement upon the Policy
herewith. For the latest list of insurance ombudsman, please refer to the IRDAI itself or by a separate instrument under notice to the Company.
website at http://www.irdaindia.org/ins_ombusman.htm. 3. The instrument of assignment should indicate the fact of transfer or
c) The complaint should be made in writing and duly signed by the complainant or assignment and the reasons for the assignment or transfer, antecedents of the
by his legal heirs with full details of the complaint and the contact information of assignee and terms on which assignment is made.
complainant. 4. The assignment must be signed by the transferor or assignor or duly
authorized agent and attested by at least one witness.
d) Also please note that as per provision 13(3) of the Redressal of Public
Grievances Rules 1998, the complaint to the Ombudsman can be made 5. The transfer of assignment shall not be operative as against the Company until
a notice in writing of the transfer or assignment and either the said
i) Only if the grievance has been rejected by the grievance redressal mechanism endorsement or instrument itself or copy there of certified to be correct by both
of the Company transferor and transferee or their duly authorized agents have been delivered
ii) The complaint should be filed within a period of one year from the date of to the Company.
rejection by the Company 6. Fee to be paid for assignment or transfer can be specified by the IRDAI
through Regulations.
iii) The complaint should not be simultaneously under any litigation
7. On receipt of notice with fee, the insurer should Grant a written
acknowledgement of receipt of notice. Such notice shall be conclusive
evidence against the Company of duly receiving the notice.
Annexure 2 8. If the Company maintains one or more places of business, such notices shall
be delivered only at the place where the Policy is being serviced.
Bajaj Allianz CSC Bachat plus – Standard Mortality Charges 9. The Company may accept or decline to act upon any transfer or assignment or
endorsement, if it has sufficient reasons to believe that it is (a) not bona-fide or
Annual Mortality Charge Rates Per ‘000 Sum at Risk (b) not in the interest of the Policyholder / Life Assured or (c) not in public
Age Mortality Charge Age Mortality Charge interest or (d) is for the purpose of trading of the Policy.
14 0.73 40 2.35 10. Before refusing to act upon endorsement, the Company should record the
reasons in writing and communicate the same in writing to Policyholder within
15 0.81 41 2.56 30 days from the date of Policyholder giving a notice of transfer or assignment.
16 0.89 42 2.81 11. In case of refusal to act upon the endorsement by the Company, any person
17 0.96 43 3.09 aggrieved by the refusal may prefer a claim to IRDAI within 30 days of receipt
18 1.03 44 3.42 of the refusal letter from the Company.
19 1.08 45 3.79 12. The priority of claims of persons interested in the Policy would depend on the
date on which the notices of assignment or transfer is delivered to the
20 1.13 46 4.23 Company; where there are more than one instruments of transfer or
21 1.16 47 4.72 assignment, the priority will depend on dates of delivery of such notices. Any
dispute in this regard as to priority should be referred to IRDAI.
22 1.19 48 5.27
23 1.21 49 5.87 13. Every assignment or transfer shall be deemed to be absolute assignment or
transfer and the assignee or transferee shall be deemed to be absolute
24 1.22 50 6.52 assignee or transferee, except
25 1.24 51 7.21 a. where assignment or transfer is subject to terms and conditions of transfer or
26 1.25 52 7.93 assignment OR
27 1.26 53 8.69 b. where the transfer or assignment is made upon condition that
28 1.28 54 9.46 i. the proceeds under the Policy shall become payable to Policyholder or
29 1.31 55 10.27 Nominee(s) in the event of assignee or transferee dying before the Life
Assured OR
30 1.34 56 11.10
ii. the Life Assured surviving the Policy Term
31 1.38 57 11.98
Such conditional assignee will not be entitled to obtain a loan on Policy or
32 1.43 58 12.91 surrender the Policy. This provision will prevail notwithstanding any law or
33 1.49 59 13.90 custom having force of law which is contrary to the above position.
34 1.56 60 15.75 14. In other cases, the Company shall, subject to terms and conditions of
35 1.65 61 17.77 assignment, recognize the transferee or assignee named in the notice as the
absolute transferee or assignee and such person
36 1.75 62 19.19
a. shall be subject to all liabilities and equities to which the transferor or assignor
37 1.87 63 20.75 was subject to at the date of transfer or assignment and
38 2.01 64 22.48 b. may institute any proceedings in relation to the Policy
39 2.17 65 24.39 c. obtain loan under the Policy or surrender the Policy without obtaining the
consent of the transferor or assignor or making him a party to the proceedings
Note:
15. Any rights and remedies of an assignee or transferee of the Policy under an
i. The above charges are exclusive of any service tax or cess. assignment or transfer effected before commencement of the Insurance Laws
(Amendment) Ordinance, 2014 shall not be affected by this section.
ii. Sum at risk is Max[Death benefit – Policy Account Value (PAV), zero]
[Disclaimer: This is not a comprehensive list of amendments of Insurance
Laws (Amendment) Ordinance, 2014 and only a simplified version prepared
for general information. Policy Holders are advised to refer to Original
Ordinance Gazette Notification dated December 26, 2014 for complete and

Bajaj Allianz Life Insurance Co. Ltd. Policy Document Ver. 1 (0672015)
Bajaj Allianz CSC Bachat Plus
A Variable Insurance Plan
UIN: 116N132V01
accurate details. ]
Annexure BB
Section 39 of the Insurance Act, 1938 – Nomination by Policyholder
Nomination of a life insurance Policy is as below in accordance with Section 39
of the Insurance Act, 1938 as amended by Insurance Laws (Amendment)
Ordinance dated 26.12.2014. The extant provisions in this regard are as
follows:
1. The Policyholder of a life insurance Policy on his own life may nominate a
person or persons to whom money secured by the Policy shall be paid in the
event of his death.
2. Where the Nominee is a minor, the Policyholder may appoint any person to
receive the money secured by the policy in the event of Policyholder’s death
during the minority of the Nominee. The manner of appointment to be laid
down by the Company.
3. Nomination can be made at any time before the maturity of the Policy.
4. Nomination may be incorporated in the text of the Policy itself or may be
endorsed on the Policy communicated to the Company and can be registered
by the Company in the records relating to the Policy.
5. Nomination can be cancelled or changed at any time before Policy matures, by
an endorsement or a further endorsement or a will as the case may be.
6. A notice in writing of change or cancellation of nomination must be delivered to
the Company for the Company to be liable to such Nominee. Otherwise,
Company will not be liable if a bona-fide payment is made to the person named
in the text of the Policy or in the registered records of the Company.
7. Fee to be paid to the Company for registering change or cancellation of a
nomination can be specified by the IRDAI through Regulations.
8. On receipt of notice with fee, the Company should grant a written
acknowledgement to the Policyholder of having registered a nomination or
cancellation or change thereof.
9. A transfer or assignment made in accordance with section 38 of Insurance Act,
1938, shall automatically cancel the nomination except in case of assignment
to the Company or other transferee or assignee for purpose of loan or against
security or its reassignment after repayment. In such case, the nomination will
not get cancelled to the extent of Company’s or transferee’s or assignee’s
interest in the Policy. The nomination will get revived on repayment of the loan.
10. The right of any creditor to be paid out of the proceeds of any Policy of life
insurance shall not be affected by the nomination.
11. In case of nomination by Policyholder whose life is insured, if the Nominees die
before the Policyholder, the proceeds are payable to Policyholder or his heirs
or legal representatives or holder of succession certificate.
12. In case Nominee(s) survive the person whose life is insured, the amount
secured by the Policy shall be paid to such survivor(s).
13. Where the Policyholder whose life is insured nominates his/her (a) parents or
(b) spouse or (c) children or (d) spouse and children or (e) any of them
The Nominees are beneficially entitled to the amount payable by the Company
to the Policyholder unless it is proved that Policyholder could not have
conferred such beneficial title on the Nominee having regard to the nature of
his title.
14. If Nominee(s) die after the Policyholder but before his share of the amount
secured under the Policy is paid, the share of the expired Nominee(s) shall be
payable to the heirs or legal representative of the Nominee(s) or holder of
succession certificate of such Nominee(s).
15. The provisions of sub-section 7 and 8 (13 and 14 above) shall apply to all life
insurance Policies maturing for payment after the commencement of
Insurance Laws (Amendment) Ordinance, 2014 (i.e., 26.12.2014).
16. If Policyholder dies after maturity but the proceeds and benefit of the Policy
has not been paid to him because of his death, his Nominee(s) shall be entitled
to the proceeds and benefit of the Policy.
17. The provisions of section 39 of the Insurance Act, 1938, are not applicable to
any life insurance Policy to which section 6 of Married Women’s Property Act,
1874, applies or has at any time applied except where before or after
Insurance Laws (Ordinance) 2014, a nomination is made in favour of spouse
or children or spouse and children whether or not on the face of the Policy it is
mentioned that it is made under section 39 of the Insurance Act, 1938. Where
nomination is intended to be made to spouse or children or spouse and
children under section 6 of MWP Act, it should be specifically mentioned on the
Policy. In such a case only, the provisions of section 39 of Insurance Act, 1938,
will not apply.
[Disclaimer: This is not a comprehensive list of amendments of Insurance
Laws (Amendment) Ordinance, 2014 and only a simplified version prepared
for general information. Policy Holders are advised to refer to Original
Ordinance Gazette Notification dated December 26, 2014 for complete and
accurate details. ]
Bajaj Allianz Life Insurance Co. Ltd.
Annexure CC
Section 45 – Policy shall not be called in question on the ground of mis-
statement after three years
Provisions regarding Policy not being called into question in terms of section
45 of the Insurance Act, 1938, as amended by Insurance Laws (Amendment)
Ordinance dated 26.12.2014 are as follows:
1. No Policy of life insurance shall be called in question on any ground
whatsoever after expiry of three (3) years from (a) the Policy Commencement
Date or (b) the Date of Commencement of Risk or (c) the date of latest revival
of the Policy or (d) the Date of Commencement of Rider; whichever is later.
2. On the ground of fraud, a Policy of life insurance may be called in question
within three (3) years from (a) the Policy Commencement Date or (b) the Date
of Commencement of Risk or (c) the date of latest revival of the Policy or (d) the
Date of Commencement of Rider; whichever is later.
3. For this, the Company should communicate in writing to the Company or legal
representative or Nominee or assignees of Policyholder, as applicable,
mentioning the ground and materials on which such decision is based.
4. Fraud means any of the following acts committed by Life Assured or
Policyholder or by his agent, with the intent to deceive the Company or to
induce the Company to issue the life insurance Policy:
a. The suggestion, as a fact of that which is not true and which the Company does
not believe to be true;
b. The active concealment of a fact by the Company having knowledge or belief
of the fact;
c. Any other act fitted to deceive; and
d. Any such act or omission as the law specifically declares to be fraudulent.
5. Mere silence is not fraud unless, depending on circumstances of the case, it is
the duty of the Life Assured or Policyholder or his agent keeping silence to
speak or silence is in itself equivalent to speak.
6. No Insurer shall repudiate a life insurance Policy on the ground of Fraud, if the
Life Assured or Policyholder / beneficiary can prove that the misstatement was
true to the best of his knowledge and there was no deliberate intention to
suppress the fact or that such mis-statement of or suppression of material fact
are within the knowledge of the insurer. Onus of disproving is upon the
Policyholder, if alive, or beneficiaries.
7. Life insurance Policy can be called in question within three (3) years on the
ground that any statement of or suppression of a fact material to expectancy of
life of the Life Assured or Policyholder was incorrectly made in the Proposal
Form or other documents, basis which Policy was issued or revived or Rider
issued. For this, the Company should communicate in writing to the Life
Assured or Policyholder or legal representative or Nominee or assignees of
Policyholder, as applicable, mentioning the ground and materials on which
decision to repudiate the Policy of life insurance is based.
8. In case repudiation is on ground of mis-statement and not on fraud, the
premium(s) collected on Policy till the date of repudiation shall be paid to the
Policyholder or legal representative or Nominee or assignees of Policyholder,
within a period of 90 days from the date of repudiation.
9. Fact shall not be considered material unless it has a direct bearing on the risk
undertaken by the Company. The onus is on Company to show that if the
Company had been aware of the said fact, no life insurance Policy would have
been issued to the Policyholder.
10. The Company can call for proof of age at any time if he is entitled to do so and
no Policy shall be deemed to be called in question merely because the terms of
the Policy are adjusted on subsequent proof of age of Life Assured. So, this
Section will not be applicable for questioning age or adjustment based on
proof of age submitted subsequently.
[Disclaimer: This is not a comprehensive list of amendments of Insurance
Laws (Amendment) Ordinance, 2014 and only a simplified version prepared
for general information. Policy Holders are advised to refer to Original
Ordinance Gazette Notification dated December 26, 2014 for complete and
accurate details. ]
Policy Document Ver. 1 (072015)
Bajaj Allianz CSC Bachat Plus
A Variable Insurance Plan
UIN: 116N132V01

Annexure 1
Office of the Contact Details Areas of Jurisdiction
Ombudsman

AHMEDABAD Office of the Insurance Ombudsman,2nd floor, Ambica House, Near C.U. Shah College,5, Navyug Colony, Ashram Road, Ahmedabad – Gujarat, Dadra & Nagar Haveli, Daman and Diu.
380 014.Tel.: 079 - 27546150 / 27546139, Fax: 079 - 27546142 Email: bimalokpal.ahmedabad@gbic.co.in
BENGALURU Office of the Insurance Ombudsman, Jeevan Soudha Building,PID No. 57-27-N-19 Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Karnataka.
Phase, Bengaluru – 560 078.Tel.: 080 - 26652048 / 26652049, Email: bimalokpal.bengaluru@gbic.co.in
BHOPAL Office of the Insurance Ombudsman, Janak Vihar Complex, 2nd Floor, 6, Malviya Nagar, Opp. Airtel Office,Near New Market,Bhopal – Madhya Pradesh, Chattisgarh.
462 003.Tel.: 0755 - 2769201 / 2769202 Fax: 0755 - 2769203, Email: bimalokpal.bhopal@gbic.co.in
BHUBANESHWAR Office of the Insurance Ombudsman,62, Forest park, Bhubneshwar – 751 009. Tel.: 0674 - 2596461 /2596455 Fax: 0674 - 2596429, Orissa
Email: bimalokpal.bhubaneswar@gbic.co.in
CHANDIGARH Office of the Insurance Ombudsman, S.C.O. No. 101, 102 & 103, 2nd Floor, Batra Building, Sector 17 – D, Chandigarh – 160 017.Tel.: Punjab, Haryana, Himachal Pradesh, Jammu &
0172 - 2706196/ 2706468 Fax: 0172 - 2708274, Email: bimalokpal.chandigarh@gbic.co.in Kashmir, Chandigarh.

CHENNAI Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet,CHENNAI – 600 018.Tel.: 044 - Tamil Nadu, Pondicherry Town and Karaikal (which
24333668 / 24335284 Fax: 044 - 24333664, Email: bimalokpal.chennai@gbic.co.in are part of Pondicherry).

DELHI Office of the Insurance Ombudsman,2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi – 110 002.Tel.: 011 - 23239633 / Delhi
23237532 Fax: 011 - 23230858 Email: bimalokpal.delhi@gbic.co.in

GUWAHATI Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Nr. Panbazar over bridge, S.S. Road,Guwahati – 781001(ASSAM).Tel.: Assam, Meghalaya, Manipur, Mizoram, Arunachal
0361 - 2132204 / 2132205 Fax: 0361 - 2732937 Email: bimalokpal.guwahati@gbic.co.in Pradesh, Nagaland and Tripura.

HYDERABAD Office of the Insurance Ombudsman,6-2-46, 1st floor, "Moin Court",Lane Opp. Saleem Function Palace, A. C. Guards, Lakdi-Ka- Andhra Pradesh,Telangana,Yanam and part of
Pool,Hyderabad - 500 004.Tel.: 040 - 65504123 / 23312122 Fax: 040 - 23376599 Email: bimalokpal.hyderabad@gbic.co.in Territory of Pondicherry.

JAIPUR Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005.Tel.: 0141 - 2740363, Rajasthan.
Email: bimalokpal.jaipur@gbic.co.in

ERNAKULAM Office of the Insurance Ombudsman,2nd Floor, Pulinat Bldg.,Opp. Cochin Shipyard, M. G. Road,Ernakulam - 682 015.Tel.: 0484 - Kerala, Lakshadweep, Mahe-a part of Pondicherry.
2358759 / 2359338 Fax: 0484 - 2359336, Email: bimalokpal.ernakulam@gbic.co.in
KOLKATA Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 4th Floor, 4, C.R. Avenue, KOLKATA - 700 072. Tel.: 033 - 22124339 / West Bengal, Bihar, Sikkim,Jharkhand, Andaman &
22124340 Fax : 033 - 22124341, Email: bimalokpal.kolkata@gbic.co.in Nicobar Islands.

MUMBAI Office of the Insurance Ombudsman,3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W),Mumbai - 400 054.Tel.: 022 - 26106552 Goa, Mumbai Metropolitan Region excluding Navi
/ 26106960, Fax: 022 - 26106052, Email: bimalokpal.mumbai@gbic.co.in Mumbai & Thane.
PUNE Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 2nd Floor, C.T.S. No.s. 195 to 198,N.C. Kelkar Road, Narayan Peth,Pune – Maharashtra,Area of Navi Mumbai and Thane
411 030.Tel.: 020 - 32341320,Email: bimalokpal.pune@gbic.co.in excluding Mumbai Metropolitan Region.
LUCKNOW Office of the Insurance Ombudsman,6th Floor, Jeevan Bhawan, Districts of Uttar Pradesh : Laitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra,
Phase-II,Nawal Kishore Road, Hazratganj, Lucknow - 226 001. Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich,
Tel.: 0522 - 2231330 / 2231331,Fax: 0522 - 2231310, Email: Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur,
bimalokpal.lucknow@gbic.co.in Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia,
Sidharathnagar.

Bajaj Allianz Life Insurance Co. Ltd. Policy Document Ver. 1 (072015)